Active NPI
Kristin L Mainville, MS, LPC
- Professional Counselor
- Brookfield, WI
National Provider Identifier
1427226901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4010-125
- Practice address
- 16535 W Bluemound Rd
Suite 200
Brookfield, WI 53005-5936 - Phone
- (262) 789-1191
- NPI assigned
- Feb 18, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4010-125 | WI | Primary |
Addresses
Primary practice location
16535 W Bluemound Rd
Suite 200
Brookfield, WI 53005-5936
Mailing address
14775 W Mayflower Dr
New Berlin, WI 53151-6757
Phone (414) 333-5096
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4010-125 | WI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232841600000",
"number": "1427226901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14775 W MAYFLOWER DR",
"city": "NEW BERLIN",
"state": "WI",
"postal_code": "531516757",
"telephone_number": "414-333-5096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16535 W BLUEMOUND RD",
"address_2": "SUITE 200",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530055936",
"telephone_number": "262-789-1191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAINVILLE",
"first_name": "KRISTIN",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "MS, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-18",
"last_updated": "2009-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "4010-125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.